| NPI | 1912900416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: NJ 25MA06867000) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MAO6867000) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2024-04-30 |